What do you imagine the halls of a juvenile detention facility sound like? Loud and rowdy? These youth weren’t incarcerated for being docile and submissive, after all, so it would seem highly unlikely one could find a quiet spot in such an institution, right? But, according to some, the sounds of juvenile detention centers have changed drastically over the past several decades -- they've gotten a lot quieter -- largely due to the use of prescription sedation. A study released this week by Youth Today suggests that children behind bars are being overmedicated and given anti-psychotic drugs when they have no applicable mental diagnosis. While gone are the days of tying unruly juvenile offenders down, the organization says there is much evidence pointing to the use of these powerful drugs as the new restraints.
Called “atypicals," these anti-psychotic drugs are intended for severe mental illnesses, particularly schizophrenia and bipolar disorder. This group of drugs emerged in the 1990s but many of them were being prescribed to incarcerated juveniles long before they were approved for use in adolescents. Abilify, Risperdal, Seroquel and Zyprexa are some of the drugs included in this classification. Another, Geodon, is still not approved for youth -- though that doesn’t mean officials at juvenile facilities aren't using them.
The Youth Today investigation asked officials in all 50 states for information on their use of atypicals and the diagnosis they were prescribed to treat. For a variety of reasons, only 16 states responded, and their openness varied widely.
Of the states who responded wholly to Youth Today’s requests (there were only 5), 3,709 out of 5,299 atypical prescriptions were filled for diagnoses other than schizophrenia and bipolar disorder, or 70 percent. General mood disorders, ADHD and post traumatic stress disorder made up the bulk of the other diagnoses.
This, Youth Today says, is evidence of the overuse of atypical drugs in detention facilities. And with little research to back the use of such potent anti-psychotic drugs in the treatment of minor mental disorders like ADHD, their rationale is persuasive.
But are these facilities intentionally using the atypicals for sedation, to have a more easily managed population, or is it better explained by the lack of mental health resources within the facilities and an explosion in the number of mentally ill kids being locked up? (Read more after the jump.)
Over the past decade and particularly within the past few years, mental health resources at a community level have gone to nil. This is true whether you are looking at juvenile or adult mental health treatment. Because the resources don’t exist within the communities, prisons and juvenile detention centers have become the modern day asylums.
In Ohio, Governor Ted Strickland approved a 34 percent cut in community mental health programs to help solve a budget crisis. Had he been thinking ahead, he would’ve realized the money saved would be spent to incarcerate many of the same people whose illness would become unmanageable without community resources.
In a 2006 report from the Office of Juvenile Justice and Delinquency Prevention, it was found that an estimated 60 percent of male and 70 percent of female juveniles detained in secure facilities had a mental health diagnosis upon entry. Many of them no doubt came into the system already on a prescription regimen.
Once in the system, juveniles are lucky if they receive the mental health programming they need. The group Models for Change released a report a few months ago that found at one facility in their state of Illinois, 98 percent of the juvenile prison population was on psychiatric medication, though the single psychiatrist at the location was only contracted to work 12 hours per week.
The Youth Today report explains that states like Texas and New Jersey have put in place measures to prevent the overmedicating of juveniles in hopes that the kids will get the help they need, rather than a temporary fix just to ease institutional life.
Indications, however, are that many states don’t see the problem with medicating juveniles to essentially keep things quiet, or perhaps they don’t understand where the problem actually lies. “It’s possible that officials do not even know if there is something to be concerned about,” says Texas Youth Commission Executive Director Cherie Townsend.
The report shows that many states don't track atypical anti-psychotic prescriptions in any meaningful way, most of their data scribbled on an offenders intake records or still kept within old-school filing cabinets. And until there is organized collection of data at both institutional and state levels, it’s likely that nothing will be done.
Elizabeth Renter is a freelance writer who studied criminal justice at Bellevue University. She blogs for several defense attorneys.